Range-of-motion (ROM) exercises are an integral part of life for people who are recovering from injury or physically restricted in movement and unable to keep muscles from losing their strength and tone. Particularly, in a nursing home setting, range of motion exercises can keep up a level of activity when a resident is unable to do so for themselves.
Range-of-motion exercises are those that involve exercising joints through the complete range of motion without causing pain. Done at least twice a day, range of motion exercises can be passive, active, or active-assistance. Passive exercises are those that use the assistance of another person in performing the activity. Active range-of-motion exercises are actually done by the person, resident, themselves. Active-assistive range-of-motion exercises are done by someone with a little help from another person.
In our daily lives, we automatically do range-of-motion exercises without giving any thought to it. But for someone who is physically limited or restricted in some way, these activities need to be done for them so their muscles don’t atrophy. All areas of the body that have movement can have range-of-motion exercises performed on them.
Starting with the neck, these exercises help reduce tension or strain from maintaining a sleep position through the night and add flexibility to the area. However, neck injuries need to be performed with the utmost caution due to the high risk of injury doing such activities.
The first movement of neck range-of-motion exercises is flexion, which is bringing the head forward so the chin touches the chest. Next is an extension where the head is brought back to alignment straight with the rest of the body. Hyperextension is tipping the head back to the chin points to the ceiling and then is brought back to extension again.
Rotation involves turning the head from side to side and is a basic movement for much of life activities. Lateral flexion is moving the head to the right and then to the left. These movements should be repeated up to five times or however many are stated in the nursing plan of the resident in the care facility.
Shoulder exercises are typically done next and are good for maintaining strength and flexibility to put clothes on and reach for items on an overbed table while lying in bed. Flexion involves raising the arm straight in front and then over the head.
The extension involves bringing the arm back down to the side and hyperextension is moving the arm behind the body, which can be done even while sitting in a chair if that is more comfortable than standing. Moving the arm straight away from the side of the body is abduction and moving it back to the side of the body is adduction.
Internal rotation is bending the elbow and raising it to the same level as the shoulder is and then moving the forearm toward the body. External rotation brings the forearm toward the head. These should also be done five times or as many times as stated in the resident’s care plan.
Elbow exercises are fairly easy and can be done standing up or sitting down. Flexion and extension involve bending the arm up to the body in a curling position and then back down again. Like doing curls with a weight bar, the arm first is straight by the side and then the forearm is brought up to lean against the bicep area of the arm.
Exercising the arm involves pronation and supination. With the arm dangling freely at the side of the body, the arm is twisted back and forth turning the palm outward and inward, etc.
Exercise of the wrist is good for healing carpal tunnel and general well being of this easily damaged area if repetitive motions are done too frequently. With the hand level, bend it down for flexion, straighten it back up for extension and bend it backward for hyperextension. Radial flexion is turning the hand back toward the thumb and ulnar flexion is turning the hand toward the little finger.
Thumb exercises can be done almost anywhere and are some of the most convenient range-of-motion exercises there are. Moving the thumb back out from the inner part of the index finger is abduction. Moving the thumb back next to the index finger is adduction. Toughing each fingertip with the thumb is called opposition. Flexion is bending the thumb into the hand and extension is moving the thumb out to the side of the fingers.
The fingers can be exercised in a similar fashion as the thumb. Abduction is spreading the fingers and the thumb apart while adduction is the opposite and bringing the fingers and thumb together. The extension is straightening the fingers so the fingers, hand, and arm are straight while flexion is making a fist.
Similar movements can be done with the knee, ankle, foot, and toes. All range-of-motion exercises are seeking to accomplish the same goal of maintaining joint flexibility and movement to keep a person functioning as independently as possible.